Towards better assessment and reduction of operative risk in coronary artery bypass grafting

The superiority of cold blood cardioplagie over crystalloid cardioplagia was extensievely confirmed by experimental and clinical data, a fact that was rarely disputed in the literature. The physiological advantage of blood cardioplagie resides less in its ability to deliver oxygen than in its buffering capacity, superior capillary flow distribution, potential for limitation of free radicals generations, preservation of endothelial function and reduction of hemodilution. Techniques of warm blood cardiopledia and normothermic cardiopulmonary bypass are more questionable and need further validation. Our initial experience with could blood cardioplegia was very convincing since the latter method reduced the negative influence of prolonged aortic cross-clamping on dysfunctional myocardium, was associated with a lower release of myocardial enzymes, and reduced markedly the volume of fluids administered perioperatively. We attempted of continuous retrograde administrations. A comparative study demonstrated that the latter method was appropriate in the clinical setting, reduced markedly the incidence of major adverse cardiac outcome and improved postoperative hemodynamicsThèse d'agrégation de l'enseignement supérieur (faculté de médecine) -- UCL, 199